Long-term visual outcome and complications associated with pars planitis.
Long-term visual outcome and complications associated with pars planitis.
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DOI：
10.1016/s0161-6420(93)31567-8
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发表时间：
1993-06
期刊：
影响因子：
13.7
通讯作者：
S. M. Malinowski;J. Pulido;J. Folk
中科院分区：
文献类型：
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作者：
S. M. Malinowski;J. Pulido;J. Folk
目的：在一个同质的扁平部炎患者群体中，识别眼部并发症并统计学评估扁平部炎与多发性硬化（MS）的可能联系。方法：作者重新检查了36例患者，并回顾了另外18例患者的记录结果：原发性睫状体平坦部炎患者54例（108眼），初始平均视力20/46平均随访89.2个月后，最终平均视力（IogMAR：0.36 ± 0.50）与20/44（IogMAR：0.34 ± 0.45;P= 0.73）无统计学差异。并发症包括伴有或不伴有玻璃体积血的新生血管（7只眼，6.5%）、中重度玻璃纸视网膜病变（7只眼，6.5%）、慢性黄斑囊样水肿（CME）（9只眼，8.3%）、视力显著性白内障（16只眼，14.8%）和视网膜脱离（9只眼，8.3%）。显著的透镜混浊与视网膜脱离的风险更高相关（P= 0.004）。4例患者（7.4%）发生视神经炎，另外8例患者（14.8%）发生MS。这些数据的Kaplan-Meier分析显示，患病5年后，患者单独发生MS的风险为16.2% ± 6.2%，发生MS或视神经炎的风险为20.4% ± 6.7%。在睫状体平坦部炎诊断时存在静脉周围炎增加了这些疾病的发生率（P= 0.002）。6例患者（11.1%）有MS家族史阳性的一级relations.Conclusions：这项研究表明，在睫状体平坦部炎患者的整体良好的视力预后。有明显白内障形成的患者发生视网膜脱离的风险更大。扁平部炎诊断时的视神经炎增加了视神经炎或MS的发展风险。本研究中扁平部炎和MS之间的强相关性进一步支持了两种疾病状态之间的联系。
Purpose:To identify the ocular complications and to statistically evaluate the possible association of pars planitis with multiple sclerosis (MS) in a homogeneous population of pars planitis patients.Methods:The authors reexamined 36 patients and reviewed the records of an additional 18 patients (total: 54 patients, 108 eyes) with idiopathic pars planitis.Results:The initial mean visual acuity of 20/46 (IogMAR: 0.36 ± 0.50) was not statistically different from the final mean visual acuity of 20/44 (IogMAR: 0.34 ± 0.45;P= 0.73), after a mean follow-up of 89.2 months. Complications included neovascularization with or without associated vitreous hemorrhage (7 eyes, 6.5%), moderate to severe cellophane retinopathy (7 eyes, 6.5%), chronic cystoid macular edema (CME) (9 eyes, 8.3%), visually significant cataracts (16 eyes, 14.8%), and retinal detachment (9 eyes, 8.3%). Significant lens opacification was associated with a greater risk of retinal detachment (P= 0.004). In four patients (7.4%), optic neuritis developed, and in an additional eight patients (14.8%) MS developed. Kaplan-Meier analysis of these data showed a 16.2% ± 6.2% risk of MS solely developing in patients, and a 20.4% ± 6.7% risk of either MS or optic neuritis developing, after 5 years of disease. The presence of periphlebitis at the time of pars planitis diagnosis increased the rate of development of these conditions (P= 0.002). Six patients (11.1 %) had a family history positive for MS in a first-degree relative.Conclusions:This study demonstrates the overall favorable visual prognosis in patients with pars planitis. Patients with significant cataract formation appear to be at greater risk for retinal detachment. Periphlebitis at the time of diagnosis of pars planitis increases the risk of development of optic neuritis or MS. The strong association demonstrated between pars planitis and MS in this study further supports a link between the two disease states.